Scleral Contact Lenses · Sydney
Scleral Lenses Sydney
Clear vision and lasting comfort — even when drops aren't enough.
Scleral lenses are large-diameter gas permeable contact lenses that vault over the entire cornea, creating a reservoir of preservative-free saline that provides clear vision and continuous hydration — particularly effective for severe dry eye, Sjögren's syndrome, keratoconus and irregular corneas.
Reviewed by Dr Mark Joung, B.Optom (Hons) UNSW · Last updated May 2026
What Are Scleral Lenses
A larger lens that protects and corrects at the same time
This makes them fundamentally different from standard contact lenses. Where a soft lens sits on the cornea and relies on your natural tear film, a scleral lens creates its own hydration layer. That's why they're both corrective and therapeutic — they improve vision while actively protecting the eye's surface.
Scleral lenses were originally developed in the late 19th century and have been refined significantly over the past two decades. Advances in gas permeable materials and precision manufacturing now allow custom fitting for a wide range of corneal conditions.
Note: these are medical scleral lenses prescribed and custom-fitted by your optometrist — not cosmetic "sclera" lenses sold online for costume use.
Who Benefits from Scleral Lenses
When standard lenses and drops aren't enough
Severe dry eye & Sjögren's syndrome
Aqueous-deficient dry eye, Sjögren's syndrome, Stevens-Johnson syndrome, graft-versus-host disease. The saline reservoir continuously bathes the cornea, bypassing a compromised tear film. Co-managed with rheumatology when needed. Sjögren's affects roughly 0.5–1% of the population, with dry eye often the earliest and most debilitating symptom.
Keratoconus & irregular corneas
When the cornea is distorted, no soft lens can give reliable clear vision — the lens simply follows the irregular surface. A scleral vaults completely over the cornea, creating a smooth, fluid-filled optical interface that neutralises the distortion. The result is stable, clear vision where glasses and soft lenses have failed. Also effective for pellucid marginal degeneration, post-corneal graft, and post-surgical irregularities. Unlike Ortho-K, which reshapes a regular cornea overnight, sclerals vault over an irregular one all day.
High myopia & complex astigmatism
For patients outside the soft toric lens range, or who get unstable, fluctuating vision from soft lenses. Stable, clear optics regardless of prescription complexity.
| Feature | Scleral lens | Soft contact lens | Corneal RGP | Ortho-K |
|---|---|---|---|---|
| Rests on | Sclera (white of eye) | Cornea | Cornea | Cornea (overnight) |
| Wear schedule | Daily wear (daytime) | Daily or extended | Daily wear | Overnight only |
| Dry eye therapeutic | Yes — saline reservoir | No | No | No |
| Irregular cornea | Yes | Limited | Moderate | No |
| Comfort at insertion | Learning curve | Immediate | Adaptation needed | Worn during sleep |
| Replacement cycle | ~2 years | Daily–monthly | 1–2 years | 1–2 years |
Scleral Lenses for Dry Eye
When sclerals are right — and when they're not
Scleral lenses are a real fix for one specific kind of dry eye: the severe, aqueous-deficient kind, where the eye simply can't make enough tears. For the far more common evaporative type, they're usually not the answer. Working out which kind you have is the whole game — and it's where we start.
Where sclerals help
Aqueous-deficient & severe dry eye
Sjögren's syndrome, graft-versus-host disease, and other conditions where tear production has genuinely failed. The lens holds a reservoir of preservative-free saline against the cornea all day — it does the hydrating your tears can't. This is where the evidence is strongest: published studies show dry eye symptom scores roughly halve, and many patients wear lenses comfortably after every other option has been tried.
Where they're usually not the answer
Evaporative dry eye & MGD
The common type — meibomian glands that are blocked or sluggish, so the tears you have evaporate too fast. Sclerals don't fix the glands, and there's little evidence they help this group. The right tool here is IPL plus lid therapy, which treats the cause. We'll steer you there first.
Where sclerals sit: the international TFOS DEWS II dry eye guidelines place scleral lenses at a later step — after lubricants, anti-inflammatory drops, and in-office treatments. They're a serious option for serious disease, not a first move. That's exactly how we use them.
So we don't jump to sclerals. We start with diagnosis — meibography with our Meibovue device, tear film stability with the Medmont E300 — and work through treatments in order of intensity.
Diagnosis → IPL → drops + omega-3 → scleral lenses
For Sjögren's, the combination works well — IPL addresses any meibomian gland component, while sclerals compensate for the aqueous deficiency IPL can't fix. Co-managed with your rheumatologist where needed. This means you'll never be recommended sclerals unnecessarily — and if you do need them, the underlying dry eye has already been properly treated.
Further reading
Ready to find out if sclerals are right for you?
No referral needed. Appointments Monday to Saturday.
Book a Scleral Lens Assessment Call (02) 8765 9600How We Fit Scleral Lenses
OCT-guided precision fitting with Eyespace lenses
Initial assessment — 1 hour
Corneal and scleral mapping with anterior segment OCT. Trial lens from Eyespace diagnostic set to assess fit, vision and refraction. We check landing zone angle and clearance at 3, 6, 9, and 12 o'clock positions, plus central vault clearance.
Lens delivery — 1 hour
Your custom lenses arrive from Eyespace. We verify fit and clearance with OCT, then teach you insertion and removal technique until you're confident.
Settling review
Comfort, vision, and fit assessment. Most patients are fully adapted by this point.
6-monthly reviews
Regular monitoring to ensure continued comfort and optimal fit. Lenses typically last approximately 2 years before replacement.
What to Expect
Clear vision, an adjustment period, and a few honest caveats
How Much Do Scleral Lenses Cost in Australia
Transparent pricing so you can plan ahead
Initial Fit
$2,200
Covers your first two years
What's included
Maintenance
$1,400
Per two-year cycle
What's included
Ongoing solution costs are similar to Ortho-K lens care. We'll walk you through the full cost picture at your initial assessment.
Are Scleral Lenses Right for You
Not everyone is a candidate — here's how we assess
Glaucoma
Risk of intraocular pressure changes. Drainage devices and filtering blebs require careful assessment before fitting (Fadel & Herzberg, CLAE 2018).
Fuchs' endothelial dystrophy
Low endothelial cell density is a concern — scleral lenses may not be suitable without specialist review.
Active eye infection
Any active ocular infection or inflammation must be fully resolved before scleral lens fitting can begin.
Herpetic keratitis
A history of herpes simplex keratitis requires careful evaluation and may affect suitability for scleral wear.
Frequently Asked Questions
Scleral lenses — what patients ask us
What are the downsides of scleral lenses?
They require a learning curve for insertion and removal, daily cleaning, and some patients experience midday fogging. They're also more expensive than soft lenses. We cover all of this at your assessment so there are no surprises.
How much do scleral lenses cost in Australia?
At Concord Eyecare, the initial fitting is $2,200 including lenses, solution supply, and breakage cover. Maintenance from year 3 is $1,400 per two-year cycle, including assessment, replacement lenses, and 6-monthly review appointments. Standard contact lens health fund rebates apply.
How long do scleral lenses last?
Approximately two years before replacement is recommended. We monitor lens condition at your 6-monthly reviews and let you know when it's time.
Can scleral lenses help with dry eye?
Yes — the saline reservoir provides continuous hydration, making them particularly effective for severe dry eye including Sjögren's syndrome. We typically try IPL and other dry eye treatments first, and recommend sclerals when additional support is needed.
Are scleral lenses uncomfortable?
Most patients find them surprisingly comfortable once in place. Insertion takes practice initially, but the lens itself rests on the sclera — which has fewer nerve endings than the cornea — so discomfort is typically minimal.
What's the difference between scleral lenses and Ortho-K?
Ortho-K reshapes the cornea overnight and is removed during the day. Scleral lenses are worn during waking hours and provide vision correction and surface protection while in the eye. They're different tools for different problems — we'll help you work out which is right for you.
Find out if scleral lenses are right for you
Book a scleral lens assessment — we'll give you a straight answer.
Book a Scleral Lens Assessment
References
- Fadel D, Herzberg C. Potential contraindications to scleral lens wear. Contact Lens and Anterior Eye. 2018;41(6):S17.
- Harthan JS, et al. Therapeutic uses of scleral contact lenses for ocular surface disease: patient selection and special considerations. Clinical Optometry. 2018;10:65-74.
- Schornack MM. Scleral lenses: a literature review. Eye & Contact Lens. 2015;41(1):3-11.
- Bavinger JC, et al. Scleral lens use in dry eye syndrome. Current Opinion in Ophthalmology. 2015;26(4):319-324.
- Craig JP, et al. TFOS DEWS II Definition and Classification Report. The Ocular Surface. 2017;15(3):276-283.
Serving Sydney families: Concord · Drummoyne · Abbotsford · Burwood · Five Dock · Strathfield · Homebush · Rhodes
Let's find the right lens for you
No referral needed. Appointments Monday to Saturday.
Book a Scleral Lens Assessment Call (02) 8765 9600